Neuro Flashcards by Alice Hanton

Extradural (middle meningeal)

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Subdural (bridging vein)

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what type of bleed has loss of consciousness (typically immediately after a head injury) followed by a period of lucidity

Extradural

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Sub arach

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When is endarterectoy indicated

stroke/TIA

mod/severe stenosis on USS (>50% stenosed)

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TACI has which of:
1. unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
2. homonymous hemianopia
3. higher cognitive dysfunction e.g. dysphasia

All 3

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PACI has which of:
1. unilateral hemiparesis and/or hemisensory loss of the face, arm & leg
2. homonymous hemianopia
3. higher cognitive dysfunction e.g. dysphasia

2 of them

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LACI has what presentation (lacunar infarct)

presents with 1 of the following:
1. unilateral weakness (and/or sensory deficit) of face and arm, arm and leg or all three.
2. pure sensory stroke.
3. ataxic hemiparesis

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POCI presents with

presents with 1 of the following:
1. cerebellar or brainstem syndromes
2. loss of consciousness
3. isolated homonymous hemianopia

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How long is the thrombolysis window

4.5 hours

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how long to avoid driving after a stroke

at least a month

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what is ROSIER for

stroke mimics

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Mx of a TIA

300mg aspirin if no CI and 24h review in TIA clinic (if it happened in the last 7 days, if >7 days then 7 days until clinic)

If they already take low dose aspirin then just continue that until specialist review.

Specialist will prob start clopi and high dose statin, plus MRI and carotid USS

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Brocas aphasia description and what lobe of brain?

Comprehension normal but speech impaired, frontal lobe

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Wernickes aphasia description and what lobe of brain?

Fluent speech but poor comprehension. Temporal lobe (near ears)

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What is malignant MCA sydrome

cerebral oedema following MCA stroke

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type of headache worsened by physical activity

migraine

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Seizure where still aware but have focal motor/sensory/autonomic sx, no post ictal

simple focal

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seizure where awareness impaired, have focal motor/sensory/autonomic sx, post ictal confusion

complex focal eg TLE

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seizure that begins focally but then becomes convulsive generally

secondary generalised (still a type of focal)

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seizure with sudden jerk of limb

myoclonic (generalised)

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seizure with sudden loss of muscle tone, ‘drop attacks’

atonic (generalised)

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seizure of baby <1 with clusters of sudden tonic flexion

infantile spasms (generalised)

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generalised seizure generally first line

valproate

focal seizure generally first line

carbamaz/lamotrigine

Kernigs and brudzinskis which is which

kernigs legs brudz- neck

Benpen doses for stat IM in meningococcal meningitis in the community

<1y 300mg 1-9y 600mg >10y and adult 1200mg

Central venous thrombosis rx

thrombolysis and long term warfarin

Neck pain, ataxic gait, UMN signs in legs

cervical spondylitic myleopathy

cervical spondylitic myleopathy rx

surgical decompression

Weakness and sensory deficit developing over more than 8 weeks CSF shows high protein and low leukocytes

Chronic inflammatory demyelinating polyneuropathy

Cluster headache rx

100% O2 SC triptan verapamil for prophylaxis

bilat intention tremor that is relieved by alcohol

essential tremor

mx options for essential tremor

propranolol or primidone could reduce it

What classically precedes GBS

campylobacter

What is the neurology in GBS

ascending weakness of all 4 limbs but proximal before distal No sensory features Areflexia

headaches, visual disturbances and pulsatile tinnitus

Idiopathic IC HTN

IICH rx

weight loss acetazolomide if visual loss on presentation

Upper and lower motor neuron signs No sensory features Fasciculations

Motor neurone

MND rx

riluzole can prolong life in AML BIPAP at night

3 types of MS

relapsing remitting - can progress to secondary progressive primary progressive

Rx acute MS relapse

steroids (reduces length of flare only)

General MS rx

DMARDs or symptomatic

Rx for fatigue in MS

amantidine

Rx of spacisity in MS

baclofen/gabapentin

Rx of bladder dysfunction in MS

intermittent self catheterisation Anticholinergics

Rx visual field oscillations in MS

gabapentin

Urinary incontinence Erectile dysfunction Parkinsonism REM sleep disorder

Multi system atrophy

Severe unilateral headache associated with lacrimation that completely resolves with indomethacin

Paroxysmal hemicrania

Fluctuating muscle weakness that is worse on repetitive movements and improves with rest

myaesthenia gravis

MG rx

AChEi Immune suppression Plasma exchange/IVIg Thymectomy

What nerve is damaged: motor: paralysis of knee flexion and all movements below knee sensory: loss below knee reflexes: ankle + plantar lost, knee jerk intact

Sciatic (L4-S3)

Horizontal diploplia nerve

CN6 (Lateral rectus 6- lateral like horizontal)

Vertical diploplia nerve

CN4 (contralateral side as it crosses, superior oblique- superior like vertical)

Mx acute ischaemic stroke of proximal anterior circulation who present within 4.5 hours

thrombolysis AND thrombectomy

triptans are c/i in hx of

IHD

migraine prophylaxis

propranolol or topiramate (propran in childbearing age woman)

Acute migraine treatment

triptan (nasal in teens) second line: metoclopramide or prochlorperazine

Confusion, gait ataxia, nystagmus + ophthalmoplegia

wernickes

the homonymous hemianopia and the paresis are always on the same or different sides

same side

Bitemporal hemianopia, upper quadrant defect

pituitary tumour

Bitemporal hemianopia, lower quadrant defect

craniopharyngioma

tuberous sclerosis- benign tumours can be in brain, can cause epilepsy

eponymous sign: multiple sclerosis complains of tingling in her hands which comes on when she flexes her neck

Lhermittes

Dysphagia plus eye weakness/ptosis =?

Myaesthenia Gravis

Encephalitis symptoms with bilat temporal lobe changes on CT suggests

Herpes simplex encephalitis

Autoimmune encephalitis is typically the result of ..?

A paraneoplastic syndrome (usually secondary to small cell lung cancer or ovarian teratoma)

Cryptococcal meningoencephalitis typically affects what demographic?

Those with severe immunodeficiency (especially AIDS). It has a subacute presentation, with symptoms progressing over several weeks (as opposed to a few days).

CMV encephalitis typically affects?

almost always occurs in patients with severe immunodeficiency. In those with HIV, it typically occurs once the CD4 count is <50.

first line AEDs for diff types of epilepsy

Give sodium valproate for all unless your female (preg/repoductive age) or they're focal. Lamotrigine/Levetriacitem otherwise Ethosuximide for absence (avoid CBZ)

After stroke if aspirin and clopi c/i what to give

MR dipyridamole

Neuro Flashcards

(72 cards)